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[轴性脊柱关节炎的分类与诊断——历史、现状及展望]

[CLASSIFICATION AND DIAGNOSIS OF AXIAL SPONDYLOARTHRITIDES – HISTORY, PRESENT STATE, AND PERSPECTIVES].

作者信息

Grazio Simeon

出版信息

Reumatizam. 2016;63 Suppl 1:1-17.

Abstract

Spondyloarthritis (SpA) is a group of inflammatory rheumatic diseases that share some common genetic, clinical, serological, radiological, and prognostic features. Since the early 1960s, several classification criteria for SpA have been proposed, and some of them were also used for diagnostic purposes. The ASAS international group of experts established a set of classification criteria for SpA, dividing them into axial or peripheral, according to predominant involvement. The paradigmatic entity of axial SpA is ankylosing spondylitis, which is diagnosed in clinical practice with significant delay. Therefore the ASAS classification introduced the term “non-radiographic axial SpA”, which refers to changes in the sacroiliac joints seen on MRI, but not on radiograph. Although the ASAS classification has been widely accepted in the professional community, recently initiatives were raised suggesting changes and aiming at improvements. In this paper these objections are discussed, as well as the responses of experts who consider that these changes are not necessary.

摘要

脊柱关节炎(SpA)是一组炎性风湿性疾病,具有一些共同的遗传、临床、血清学、放射学和预后特征。自20世纪60年代初以来,已经提出了几种SpA的分类标准,其中一些也用于诊断目的。ASAS国际专家小组建立了一套SpA分类标准,根据主要受累部位将其分为轴向型或外周型。轴向SpA的典型疾病是强直性脊柱炎,在临床实践中诊断时存在显著延迟。因此,ASAS分类引入了“非放射学轴向SpA”这一术语,它指的是在MRI上可见但在X线片上未见的骶髂关节变化。尽管ASAS分类已在专业领域广泛接受,但最近有人提出倡议,建议进行更改并旨在改进。本文讨论了这些反对意见,以及认为这些更改没有必要的专家的回应。

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